# Primary left intrathoracic extrapulmonary trans-diaphragmatic hydatid cyst causing eventration: first case in literature

## TL;DR

A rare case of a hydatid cyst in a woman's chest caused by a parasitic infection is reported, highlighting the challenges in diagnosis and treatment.

## Contribution

This is the first reported case of a primary left intrathoracic extrapulmonary hydatid cyst causing eventration in the literature.

## Key findings

- A 62-year-old female presented with a rare hydatid cyst in an unusual thoracic location.
- Surgical cystotomy and evacuation with povidone and hyperosmolar saline were performed due to proximity to the pericardium.
- The cyst's location significantly influenced the surgical approach and complete resection possibility.

## Abstract

Hydatidosis is a zoonotic parasitic disease caused by the cystic stage of Echinococcus species. Intrathoracic extrapulmonary hydatid cysts causing eventration are very rare. Here, we report a case of a 62-year-old female who presented with chest pain, intermittent coughing, general weakness, and fever. On auscultation, there were diminished respiratory sounds at the base of the left lung. A computed tomography scan showed a cystic formation with an ambiguous location involving the left lower thorax and the left hypochondrium. Complete surgical resection is the standard treatment for intrathoracic extrapulmonary hydatid cysts. Due to the direct bordering of the cyst with the pericardium in the left cadiophrenic angle, a cystotomy and evacuation of the cystic cavity were performed, followed by washing it with povidone and hyperosmolar saline. The location of the hydatid cyst has an important role in determining the surgical approach, as the unusual location could affect the possibility of radically removing the cyst.